FNU 322 - Advanced Nutrition 2

what are features of vitamin D deficiency?

- causes a calcium deficiency - leads to overt signs only rarely - may result from breastfeeding without supplementation

water

- is the fluid which all life processes occurs - everything we do that requires energy uses fluids in our bodies

describe the characteristics of vitamins

- organic, but do not produce energy - facilitate the release of energy from carbs, fat, and protein - 13 kinds - can only function when intact, but being complex organic molecules, they are vulnerable to destruction by heat, light, and chemical agents

what is among the factors required for efficient dietary absorption of vitamin B12?

- pepsin - hydrochoric acid - intrinstic factor

3 ways vitamins differ from macros

- structure: vitamins are individual units; they are not linked together - function: vitamins do not yield energy when metabolized; many of them do, however, assist the enzymes that participate in the release of energy from macros - food contents: amounts of vitamins people ingest from foods and the amounts they require daily are measured in micro-grams or milligrams

categories of body fluid

- water (main) - plasma of cells - lymph - blood

Approximately what percentage of the body's calcium is found in the blood?​

1

At what age do adults normally begin to lose bone mass?​

30-40

What %IBW indicates a risk for moderate malnutrition?​

70-79

An individual who is at risk of moderate malnutrition has a %UBW of ____ percent.​

75-84

Mrs. Wish: 70 years old, height is 5'6", current weight 100 lb, down from her last recorded weight of 115 lbs 3 months ago, which is her usual weight. What is her percent ideal body weight (%IBW)?

80

Mrs. Falwell is 5'4" and weighs 110 lbs. During the interview, she mentions she has lost "a lot of weight" over the past 5 months. She usually weighs 135 lbs. What is her %UBW?

81

Mrs. Falwell is 5'4" and weighs 110 lbs during the interview she mentions she has lost "a lot of weight" over the past 5 months. She usually weighs 135 lbs. What is her %UBW?

81%

an individual who is at risk of mild malnutrition has a %UBW of what?

85-94%

A BMI-for-age above the ____ percentile indicates that the child may be overweight.​

85th

Mrs. Wish: 70 years old, height is 5'6", current weight 100 lb, down from her last recorded weight of 115 lbs 3 months ago, which is her usual weight. What is her percent usual body weight (UBW)?

87

A 24-hour recall is used to collect a food and nutrition history. The client states that she didn't eat breakfast. She had a soft drink and an apple for lunch, and for dinner, she had a slice of pizza. What is the best question the health care professional could ask next regarding this finding?​

"is this a usual day's food intake?"

which calculation is most useful in evaluating weight loss in an overweight person?

%UBW

Which statement is descriptive of iron deficiency and behavior?​

Changes in behavior precede the appearance of anemia

Which factor explains why B vitamin deficiencies lead to lack of energy?

Coenzymes needed for energy metabolism are produced in insufficient amounts.

What is a characteristic of iron nutrition?

Iron deficiency and iron overload share some of the same signs and symptoms

If a dietary supplement poses a significant risk of illness to consumers, what agency must prove harm before removing the product from the market?​

FDA

What is a feature of iron absorption?​

It is higher in people with iron deficiency

Which food provides iron in the most absorb-able form?

chicken

which group of people has the highest percentage of body water?

children

what is the major extracellular anion?

chloride

what is a chief function of the b vitamins?

coenzyme participation

A nutritional assessment involves ____.​

collecting data and using it to evaluate a patient's nutrition status

coenzyme

complex organic molecules that work with enzymes to facilitate the enzymes' activity; many have B vitamins as part of their structures

which of the following is a feature of pantothenic acid in nutrition? a. a deficiency or a toxicity shows similar symptoms b. deficiencies are seen primarily in children ages 4-10 years c. it functions in the metabolism of amino acids, glucose, and fatty acids d. absorption from foods is inhibited by aspirin

d. it functions in the metabolism of amino acids, glucose, and fatty acids

fluid accumulation typically results in _____.

deceptively low lab results

keratinization of lung cells may result from what?

deficiency of vitamin A

What is a characteristic of calcium nutrition in teenagers?​

The intake of calcium is higher in boys than girls because they eat more food.

age

The strongest predictor for loss of bone density is a person's ____.​

Why are hemoglobin and hematocrit tests of limited usefulness in the assessment of iron status?​

They are late indicators of iron deficiency.

​What is a feature of physical activity and bone health?

Working the muscles places stress on bones, which promotes bone density.

folate

a person with a disorder that limits absorption of bile is at increased risk for deficiency of

which of the following is NOT among the general characteristics of the water-soluble vitamins? a. they must be consumed daily b. toxic levels in the body are rarely found c. they are absorbed directly into the blood d. excesses are eliminated by the kidneys

a. they must be consumed daily

What is shared by niacin and riboflavin coenzyme?

acceptance and transfer of hydrogen atoms

protein

What is the major source of dietary sulfur?​

Salted peanuts contain less sodium than cereals on a per-gram basis

When a person loses fluid by sweating or bleeding, what minerals are lost in greatest quantity?​

changes in hydration, as well as diarrhea due to illness, affect nutrition status primarily by _____.

altering metabolism and excretion

patient height and wight represent which type of data?

anthropometric data

most readily induces a vitamin K deficiency

antibiotic therapy

how is thiamin destroyed?

easily destroyed by heat

what is the function of MFP factor?

enhances iron absorption

what disorder may result from vitamin E deficiency in people?

erythrocyte hemolysis

Robert is being treated for hypertension with a diuretic. This is most likely to affect his nutritional status via what?

excretion

A deficiency of which vitamin results in accumulation of homocysteine in the blood?​

folate

A person with a disorder that limits absorption of bile is at increased risk for deficiency of ____.​

folate

what is true regarding B vitamins and homocysteine metabolism?

folate catabolyzes homocysteine

an extensive, accurate log of foods eaten over a period of several days or weeks is called a ______.

food record

a patient's ability to feed him or herself represents which type of data?

functional assessment data

​What may result from iodine deficiency?

goiter

What iron-containing compound carries oxygen in the bloodstream?

hemoglobin

Mrs. Sealy is an 85-year-old woman who states she has a poor appetite. She is 5'2", her current weight is 80 pounds, and her usual body weight is 115 pounds. The nurse determines that....

her %UBW is 70%

which of the following diets is most likely to lead to beriberi?

high intakes of white rice

Which food choice would be the only substantial source of vitamin B12?​

hot dog

Impaired nutrient digestion and absorption that affects nutritional status would most likely be manifested as ____.​

insufficient excretion of digestive enzymes

what is a feature of vitamin K?

it participates in synthesis of bone proteins

which disease is associated with a deficiency of folate?

macrocytic anemia

What is the most reliable dietary source of zinc?

meats and whole-grain cereals

Where is the majority of the body's magnesium found?​

bones

What does Malnutrition mean? What symptoms malnutrition may cause?

- any condition caused by excess or deficient food energy or nutrient intake or by an imbalance of nutrients - symptoms: diarrhea, skin rashes, and fatigue

describe the characteristics of minerals

- are in structures or found in fluids of the body (influences fluid balance and distribution - do not yield energy - 16 essential in human nutrition

identify 6 nutrients and the micronutrients

- carbs - proteins - fats - vitamins - minerals - water

water-soluble vitamins

- directly enter the blood stream - travel freely in the bloodstream - excess is secreted by the kidneys - hard to reach toxic levels

how to determine a vitamin's bioavailability

- efficiency of digestion and time of transit through the GI tract - previous nutrient intake and nutrition status - method of food preparation - source of the nutrient - other foods consumed at the same time

characteristics of water-soluble vitamins

- water soluble - absorbed directly into blood - toxic levels in the body are rarely found - excesses are eliminated in urine (by kidneys) - body cannot store them, must be eaten more regularly - vitamin B and C group

other names of niacin

- nicotinic acid - nicotinamide - nicacinamide - vitamin B3 - precursor is dietary tryptophan

understand the science of nutrition

1-3 page 12 scientists learn about nutrition by conducting experiments that follow the protocol of scientific research; researchers randomly assign control and experimental groups, seek large sample sizes, provide placebos, and remain blind to treatments; findings must be reviewed and replicated by other scientists before being accepted as valid

what is a feature of vitamin E in foods?

most convenience foods are poor sources of vitamin E

what affects nutrition status by reducing food and nutrient intake?

nausea and vomiting

your friend Jane just returned from the doctor, who diagnosed her with a specific vitamin B toxicity. However, she doesn't recall the name of the vitamin. Which of the following is the only possible culprit associated with toxicity symptoms?

niacin

What term identifies the characteristic tingling sensations and reddening of the skin after ingesting a pharmacologic dose of nicotinic acid?​

niacin flush

toxicity symptoms of riboflavin

none reported

toxicity symptoms of niacin

painful flush, hives, and rash, nausea and vomiting, liver damage, impaired glucose tolerance

what is a feature of zinc in nutrition?

pancreatic enzymes are rich in zinc

Which food provides the greatest amount of iron per serving?​

pinto beans

What is the most likely explanation for the impaired functioning of the GI tract resulting from folate deficiency?​

reduced mucosal cell replacement, thereby resulting in decreased GI functioning

Which health care professional is expected to have extensive knowledge about foods and human nutrition?

registered dietitian

what healthcare professional is expected to have extensive knowledge about foods and human nutrition?

registered dietitian

A deficiency of what vitamin produces a characteristic cracking and redness at the corners of the mouth?​

riboflavin

which statement most accurately describes nutrition assessments?

screenings should be conducted within 24 hours of admission

in what system would the effects of a vitamin D deficiency be most readily observed?

skeletal

which term is a type of neural tube defect?

spina bifida

what is meant by the bioavailability of a vitamin in food?

the amount absorbed and subsequently used by the body

a nutrition care plan is _____.

the dietitian's strategies for meeting an individual's nutritional needs

length

the distance form the top of the head to the soles of the feet while a person is recumbent (laying down)

what is a characteristic of free radicals?

they arise from normal metabolic reactions

hydrophilic vitamins

water-soluble vitamins

Your friend Alex is concerned about his weight and ask whether there's an ideal body weight for him. He is 68" tall. You would respond

your ideal body weight is 154 pounds you are overweight if you weigh more than that

30

​At what age does a person reach his/her highest bone density?

taking them on an empty stomach rather than with meals

​What has been shown to improve absorption of iron from iron supplements?

Which reason is the least likely cause for an abnormal blood calcium level?​

​insufficient dietary intake

Tiffany is a strict vegan and does not consume calcium-rich plant foods or take calcium supplements. Which molecule is most responsible for maintaining her blood calcium levels in the normal range?​

​parathyroid hormone

Which foods are significant sources of oxalates?​

​spinach and sweet potatoes

approximately how much water (pounds) is found in a 134 lb person?

80

What is a feature of calcium supplements?​

Common antacids are used as a source of calcium.

Explain how bioavailability affects the functionality of vitamins within the body. Discuss how the source (from diet or supplementation) and food preparation methods affect vitamin bioavailability.

In order for the body to utilize vitamins, they must be absorbed. Factors such as the vitamin source (natural or synthetic), source food composition, method of preparation, efficiency of digestion, and baseline nutritional status all interact to affect absorption. Certain conditions related to any of these factors can lead to decreased absorption. Thus, it is important to consider these factors when evaluating vitamin adequacy. Numerous food preparation methods can be used. For example, foods may be boiled, parboiled, blanched, steamed, pureed, baked, roasted, sautéed, fried, broiled, and/or microwaved. Clinical research has produced varying opinions related to whether microwaving decreases nutrient composition. As vitamins are heat sensitive, the amount, type, and length of heat exposure does affect bioavailability. Additionally, methods whereby food products are boiled have been shown to account for vitamin loss into the surrounding fluid.

interstitial

In the body, water that resides between cells is known as ____ fluid.​

significant sources of riboflavin

Milk products (yogurt, cheese) Enriched or whole grains Liver

significant sources of niacin

Milk, eggs, meat, poultry, fish; whole-grain, fortified, and enriched grain products; nuts and all protein-containing foods

describe the interrelationships between illness and malnutrition

Patients may later their diets or undergo physiological changes that affect food intake or nutrient metabolism, potentially leading to malnutrition

deficiency disease of niacin

Pellagra: diarrhea, dementia, dermatitis, death

undernutrition

deficient energy or nurtients

deficiency symptoms of thiamin

enlarged heart, cardiac failure, muscle weakness, neurological impairment, anorexia, weight loss -poor short-term memory, confusion, irritability, apathy

kcalorie counts

estimates of food energy (and often protein) consumed by patients for one or more days

overnutrition

excess energy or nutrients

hydrophobic vitamins

fat-soluble vitamins

nutrition screening

an assessment procedure that helps to identify patients who are malnourished or at risk for malnutrition

deficiency diseases of riboflavin

ariboflavinosis; symptoms - sore throat; cracked and redness at corners of mouth; painful, smooth, purplish red tongue; inflammation characterized by skin lesions covered with greasy scaled

nutrition support teams

health care professionals responsible for the provision of nutrients by tube feeding or intravenous infusion

what is a feature of sodium and health?

high sodium intake is known to promote calcium excretion

deficiency disease of thiamin

beriberi (wet, with edema; dry, with muscle wasting)

Explain how the kidneys help to maintain fluid balance and regular blood pressure. Name the related hormones and their roles.

The kidneys reabsorb needed substances and water and excrete wastes with some water in the urine. The kidneys meticulously adjust the volume and the concentration of the urine to accommodate changes in the body, including variations in the day's food and beverage intakes. Instructions on whether to retain or release substances or water come from ADH, renin, angiotensin, and aldosterone.

1000 mg

how much sodium is contained in a fast-food deluxe hamburger that lists a salt content of 2.5 g?

FDA

if a dietary supplement poses a significant risk of illness to consumers, what agency must prove harm before removing the product from the market?

processed foods

What is the greatest single source of sodium in the diet?​

​Intake and excretion are equal

What is the relationship of the amount of sodium excreted to the amount ingested in a normal day?​

sodium and chloride

When a person loses fluid by sweating or bleeding, what minerals are lost in greatest quantity?​

what is a feature of water and nutrition?

Water intoxication is rare but can result in death

niacin

a B vitamin. The coenzyme forms are NAD (nicotinamide adenine dinucleotide) and NADP (the phosphate form of NAD); can be eaten preformed or made in the body from its precursor, tryptophan, an essential amino acid.

riboflavin

a B vitamin; coenzyme forms are FMN (flavin mononucleotide) and FAD (flavin adenine dinucleotide)

thiamin

a B vitamin; the coenzyme form is TPP (thiamin pyrophosphate) uses in energy metabolism

nutrition assessment

a comprehensive analysis of a person;s nutrition status that uses health, socioeconomic, drug, and diet histories; anthropometric measurements; physical examinations; and laboratory test

riboflavin

a deficiency of what vitamin produces a characteristic cracking and redness at the corners of the mouth

folate

a deficiency of which vitamin results in accumulation of homocysteine in the blood?

food record

a detailed log of food eaten during a specified time period, usually several days; "food diary"; may record medications, disease symptoms, and physical activity

macrocytic anemia

a disease that is associated with a deficiency of folate

Registered Dietitian

a food and nutrition expert who has completed the education and training specified by the Academy of Nutrition and Dietetics, including a bachelor's degree in nutrition or dietetics, a supervised internship, and a national registration exam

body mass index

a person's weight in relation to height; determined by dividing one's weight (kg) by the square of the height (m) or multiplying the lbs and feet by 703

24-hour dietary recall

a record of foods consumed during the previous day or in the past 24 hours;sometimes modified to include foods consumed in a typical day

What kind of Nutrition Status one person could possibly be at?

adequate, under, or over nutrition

nursing diagnosis

clinical judgments about actual or potential health problems that provide the basis for selecting appropriate nursing interventions

clinical pathways

coordinated programs of treatment that merge the care plans of different health practitioners; also called "care pathways," "care maps," or "critical pathways"

half-life

in blood tests refers to the length of time that a substance remains in plasma; the albumin in plasma has this of 14-20 days, meaning that half of the amount circulating in plasma is degraded in this time period

pressure sores

localized injuries to the skin and or underlying tissue to due prolonged pressure on the affected area by an external object (bed, wheelchair, cast); vulnerable areas of the body include buttocks, hips, and heels; a.k.a. "decubitus ulcers"

anorexia

loss of appetite

toxicity symptoms of thiamin

none reported

medical nutrition therapy

nutrition care provided by a registered dietitian; includes assessing nutrition status diagnosing nutrition problems, and providing nutrition care

explain how health professionals identify and treat patients at risk for nutrition problems

only registered dietitians are qualified to provide the medical nutrition therapy necessary for diagnosing and treating nutrition problems - nutrition screening shows risk of malnutrition, the RD may apply the nutrition care process to evaluate potential nutrition problems and implement the appropriate therapy

vitamins

organic, essential nutrients required in small amounts by the body for health; regulate body processes that support growth and maintain life

present arguments for and against the use of dietary supplements

pg 336

recognize misinformation and describe how to identify reliable nutrition information

pg 338

anthropometric

related to physical measurements of the human body, such as height, weight, body circumferences, and percentages of body fat

dairy foods

riboflavin needs are more difficult to meet when the diet is low in what?

diet orders

specific instructions regarding dietary management; also called "diet prescription," or "nutrition prescriptions"

nutrition care plans

strategies for meeting an individual's nutritional needs

precursors

substances that precede others; with regard to vitamins, compounds that can be converted into active vitamins; also known as provitamins

hypertension

the DASH diet plan was devised to prevent ______.

vitamin B12

the absorption of which vitamin is most affected by the disorder atrophic gastritis?

bioavailability

the rate at and the extent to which a nutrient is absorbed and used

which group of people is at known risk for potassium depletion?

those who ingest low amounts of fresh fruits/vegetables

When the diet contains an adequate amount of protein, what amino acid can be used by the body to synthesize niacin?​

tryptophan

How is riboflavin destroyed?

ultraviolet light and irradiation

other name of thiamin

vitamin B1

other names of riboflavin

vitamin B2

reduced mucosal cell replacement, thereby promoting fat malabsorption and diarrhea

what is the most likely explanation for the impaired functioning of the GI tract resulting from folate deficiency?

niacin flush

what term identifies the characteristic tingling sensations and reddening of the skin after ingesting a pharmacologic dose of nicotinic acid

spina bifida

which term is a type of neural tube defect?

significant sources of thiamin

whole-grain, fortified, or enriched grain products; moderate amounts in all nutritious food; pork

hyponatremia

​Abnormally low blood sodium concentration is specifically known as ____.

Amy, 16 year old sister of your friend is a cheerleader in high school and restricts her diet to control weight. She skips breakfast often, doesn't drink milk, rarely eats cheese or yogurt because she's afraid of the "fat" in dairy products. She enjoys sandwich and fountain drinks with friends at lunch, and usually eats fruits as dinner. Provide at least 3 statements if you are asked to discuss nutrition and health with Amy.

1. Amy needs to find other foods she finds suits her diet to control weight in order to make up for nutrients lost from not eating dairy - like turnip greens, bok choy, kale, parsley, watercress, broccoli, tofu, and some nuts. 2. She should look for "fat free" dairy products if she is afraid of the fat contents - even though the fat from dairy is proven to not affect body weight that way unless consumed in excessive amounts. 3. Young girls are known for not intaking enough calcium for the now and later in life for risk of osteoporosis.

Alex, 10 years old brother of your friend has recently become inactive and getting tired easily from his sports. School teacher also concerned that he's talkative in class and not paying attention in the classroom. At home, he's more irritable than usual and complains about his homework and chores. Mom worries that he has attention deficit and would bring him to a psychologist for an evaluation. Your friend mentioned that Alex is a picky eater, likes waffles and milk for breakfast, cheese pizza or grilled cheese for lunch, and frequently asks for mac and cheese for dinner. If you are asked about nutrition and health for Alex, provide at least 3 thoughts and/or suggestions on Alex's condition.

Seems like Alex has an iron deficiency and behavior problem. Signs of an iron deficiency include reduced physical work capacity and mental productivity - without the physical energy and mental alertness to work, plan, think, play, sing, or learn, Alex is doing less. His symptoms are common to be mistaken for behavioral or motivational problems, like attention deficit. Poor nutrition is always a possible contributor. 1. Seek a routine physical examination before undertaking more expensive, and possible harmful, treatment options 2. doctor could prescribe and his mother give him iron supplementation options to improve his symptoms 3. improve diet with more meats and iron fortified foods

what type of anemia results from iron deficiency?

microcytic hypochromic

what is the common characteristic of micronutrients?

micronutrients facilitate energy metabolism

iron deficiency in children is likely to result from a diet that overemphasizes _____.

milk

what may result from excessive intakes of vitmain D by adults?

mineral deposits in soft tissues such as the kidney

On a per kcalorie basis, which foods are the best sources of calcium?​

vegetables

The absorption of which vitamin is most affected by the disorder atrophic gastritis?​

vitamin B12

when the diet contains an adequate amount of protein, what amino acid can be used by the body to synthesize niacin?

vitamin B6

A similar type of anemia is produced when there is a deficiency of either ____.​

vitamin B6 or folate

which of the following vitamins has been noted as preventing the oxidation of low-density lipoproteins?

vitamin E

which of the vitamin is synthesized in significant amounts by intestinal bacteria?

vitamin k

which of the following nutrients does not yield energy during its metabolism?

vitamins

fat-soluble vitamins

- enter lymph then the bloodstream - travel in the bloodstream with help of transport - can reach toxic levels because stored in fat storage sites rather than be secreted

describe how micronutrients differ from the energy nutrients

- foods rich in the energy-yielding nutrients provide the major materials for building the body's tissues and yield energy for the body's use or storage; energy is measured in kcalories - a measure of heat energy - vitamins, minerals, and water do not yield energy; instead they facilitate a variety of activities in the body

discuss the various types of data used for evaluating an individual's nutrition and health status

- historical information: medical history, medication and supplement history, personal and social history, and food and nutrition history - anthropometric: allows the assessment of growth patterns or the presence of over nutrition or under nutrition - biochemical analysis: indicate nutrient imbalances or various other medical problems - physical examinations: can reveal signs of nutrient deficiencies, fluid imbalances, and functional impairments

explain how the four assessment methods are used to detect energy and nutrient deficiencies and excesses

- historical information: reflects a person's medical record and disease that interferes with the person's ability to eat or the body's use of nutrients (including family history), economic, and social circumstances - anthropometric measurements: relating to measurement of the physical characteristics of the body, such as height and weight - physical examination: visual inspection of the hair, eyes, skin, posture, tongue, and fingernails - laboratory tests: take samples of blood or urine, analyze them in the laboratory, and compare results with normal values for a similar population

understand and interpret the meaning of DRIs

DRIs are a set of nutrient intake values for healthy people in the United States and Canada; these values are used for planning and assessing diets and include

calcium rigor

The muscle stiffness that results from abnormally high calcium levels in the blood is termed ____.​

vitamin B12 or folate

a similar type of anemia is produced when there is a deficiency of either _____.

PES statement

a statement that describes a nutrition problem (P), the etiology or cause (E), and the sings and symptoms (S)

food frequency questionnaire

a survey of foods routinely consumed; some ask about the types of food eaten and yield only qualitative information; others include questions about portions consumed and yield semi-quantitative data as well

nutrition care process

a systematic approach used by dietetics professionals to evaluate and treat nutrition-related problems

coenzymes needed for energy metabolism are produced in insufficient amounts

which factor explains why B vitamin deficiencies lead to lack of energy?

hot dog

which food choice would be the only substantial source of vitamin B12? pecans hot dog cauliflower whole-grain bread